Pituitary Tumors

A pituitary tumor is usually an adenoma, which is a tumor that arises from the cells of the pituitary gland. Although it is usually benign (not cancerous), a pituitary tumor is not harmless. Since the pituitary gland produces critical hormones, a tumor may interfere with or destroy the gland’s function. Some pituitary tumors are “functioning” tumors, meaning the tumor itself produces hormones. The good news is that advanced new methods for diagnosing and removing pituitary tumors have made it possible for expert neurosurgeons to treat these lesions using minimally invasive techniques that leave little or no scarring (see Surgery for Pituitary Tumors).

When a pituitary tumor is said to be “functioning,” that means it’s producing one or more hormones: prolactin, adrenocorticotrophic hormone, growth hormone, or thyrotropin. Since these hormones play different roles in the body, the symptoms of a pituitary tumor can be very different depending on which hormone the tumor is producing.

The pituitary gland is located at the base of the skull, not technically within the brain itself. There are other tumors that may appear at the skull base near the pituitary gland, in an area called the sellar/parasellar region, but that are not technically pituitary tumors. These other tumors include:

• Craniopharyngiomas, germ cell tumors, and epidermoid cysts
• Meningiomas
• Gliomas
• Rathke cleft cysts
• Metastatic tumors that originate in another part of the body — commonly the breast and lung — and spread to the pituitary region and other areas of the brain

In less common cases, a pituitary tumor may be an invasive adenoma or a carcinoma. Minimally invasive surgical techniques may be used to remove any of these tumors.

What Causes a Pituitary Tumor?
Researchers don’t know for sure what causes a pituitary tumor to develop. Some people seem to have a genetic predisposition to them — if a parent or grandparent had a pituitary tumor you may be at greater risk — but many tumors are “sporadic,” meaning they simply develop for no known reason. Very rarely a pituitary adenoma can be part of a genetic/familial syndrome such as multiple endocrine neoplasia, type I (MEN1). Since pituitary tumors do not always cause symptoms, you can have one and not know it — in fact they are fairly common and may be present in up to 10 percent of the population.

At the Weill Cornell Medicine Brain and Spine Center, our neurosurgeons are highly skilled in the most advanced procedures for treating brain tumors. Our relationship with NewYork/Presbyterian Hospital allows our surgeons access to the very best facilities and specialists, as well as the most leading-edge research laboratories, to ensure that you get the very best treatment available. We use specialized imaging sequences to identify the tumors and, in some circumstances, we use a new procedure called inferior petrosal sinus sampling to identify and localize ACTH-producing tumors.

The Weill Cornell Medicine Brain and Spine Center’s Skull Base Surgery Program is headed by Dr. Theodore Schwartz and Dr Georgiana Dobri. Dr Schwartz is an internationally known expert in “endonasal endoscopic” surgical techniques in which even large pituitary tumors can be removed through the nostrils, with no incisions and no scarring. Dr. Dobri is an expert in pituitary pathology, being well versed in all available medical options for pituitary tumors, hypopituitarism, and surgical aftercare and monitoring.

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